I have read Neil Morgan’s and David Taylor’s article “Psychodynamic psychotherapy and the treatment of depression” which was published in”Psychiatry” journal in 2005. Morgan and Taylor’s article represents the psychodynamic principles about how depression develops and the effectiveness of psychotherapy based on studies. I think that the writers identify depression in a too deterministic way by emphasizing childhood at the expense of adulthood impacts.
It is widely known that the psychodynamic context highlights the signification of childhood and how strongly these early experiences follow the individual into his/her adulthood. Mostly the past is seen as influencing an unconscious path through motives and drives. This paradigm is seen in the article. It is natural taking into account the subject of the article, but honestly I was a little disappointed: the article did not introduce me any new views or ideas. Psychodynamic paradigms have been developed since Freud, but I found no proof of that in this particular article. All of the introduced theories are heritage from 20th century’s psychoanalysts.
Even though Morgan and Taylor use a concept vulnerability, and they represent depression as ”… a chronic, lifelong, relapsing condition, rather than a ’one-off’ illness.” (p. 6) and these authors describe depression as a complex phenomenon rather than a unitary phenomenon, the deterministic echo can be heard through the text. John Bowlby thinks that depression is a result of an unsuccessful attachment in childhood (p. 8), Melanie Klein’s view about the causation lies in the early loss of the mother (p. 8) and at the end of the article Morgan and Taylor claim that according to the studies parenting styles are stable and transmitted from one generation to the next (p. 8-9).
I do not refute those possible effects, not at all. However, what I want to argue, is that the article draws a picture that an individual cannot affect his/her life because everything has been determined in childhood by the actions of other people, usually parents. If we follow this scenario far enough we find ourselves with a conclusion that no one can become integrated from depression and hence there is no point of giving treatment to anyone. Why bother if the cards to a successful and unsuccessful life are already dealt in childhood?
This concept of man is very passive, fatalistic and doomed. According to these theories people are prisoners of depression and unconscious drives. Humans cannot become separated from their depression, like Sisyphus was not able to stop rolling the boulder up a hill and he was cursed repeating it forever in Greek mythology. Is depression a mental burden that people need to carry on with them through life? Is there no relief on the horizon? Are oasis just mirages?
The article does not present enough indications about the other factors that could affect developing depression. Despite the fact that the article has been written on a conditional and there is not any imperative claims that depression will absolutely evolve if early experiences are not secure and attachment has not been managed successfully. Actually, there is only one direct indication to the affect on the environment: ”…early experiences of an individual can lead to vulnerability, which, in interaction with life events, culminates in adult depression.” (p .6) Morgan and Taylor do not present enough of any other possible factors. Environmental factors are being bypassed and causation is represented too narrowly.
The article introduces the relationship between aggression and depression according to various psychodynamic theories. As if there were not enough of these thesis statements that people cannot help themselves, here comes some more: according to Melanie Klein’s theory aggression is seen as an innate, inborn power (p. 7). This example confirms the article’s tone that locates human beings at a biological based level. Besides, the theory will lead to a significant homunculus problem: where has this innate aggression evolved originally? The article gives no answer for this. Edith Jacobson describes aggression as a reactive phenomenon, not integrating damage and rage into human essence (p. 7). The latter view seems much more polymorphous to me.
What is a more confusing aspect is that the writers’ aim seems to be normalizing depression: “…our struggles with depression are part of what it is to be human.” (p. 6) In my opinion, it is not a state of normality to feel chronic anxiety, melancholia and powerless. I think this idea upwells from our individualistic culture where happiness is seen as an abnormal and brief position, which is hard to achieve. I am afraid that normalizing serious and hazardous mental problems leads us to apathy. This carelessness is about to justify depression as an innate, chronic essence and we are being stigmatized to be passive and unhappy creatures for the rest of our lives.
The article represents John Bowlby’s pioneer study with attachment theory (p. 8), which has been strictly criticized. For me it is easy to associate with the commentary: the theory fatalises people into hopelessness and satisfies destiny by their childhood, makes parents (more specifically: mothers) guilty and fits only into Western cultures. In fact, there have been studies showing that attachment theory’s yield is not so carved in stone as Bowlby has articulated: even though one might had an incomplete parenting style in childhood, later close relationships might replace these experiences and an individual can live an integrated and pleasant life. Childhood is not a ghost of the past that will haunt one the grave. Despite miserable early experiences, an individual’s life can change remarkably in adulthood and have a whole new direction and meaning.
Heinz Kohut’s theory has the same, problematic features as Bowlby’s. Kohut presents depression as a lack of good experiences in childhood and parents play dominant roles in this causation (pp. 7-8). This occurs in a phenomenon that Kohut nominates mirroring. The child learns his/her worth and amiability through this mirroring episode and this impression will command the individual’s adulthood. I do not adopt this point of view: why are other people than parents not as important in mirroring? Are the adulthood mirrors not as important and impressive as in childhood? I think that the studies against Bowlby’s theory agree on this case too. In my opinion, theories that emphasize childhood at the expense of adulthood drop into an ad hoc argument: it is easy to eliminate troubles around one’s own “perfect” theory.
Morgan and Taylor present René Spitz’s research with institutionalized infants who suffered from maternal deprivation and insufficient human interaction (p. 8). The results were dreadful: the children became passive, apathetic towards the stimuli of environment and withdrawn. Spitz argued that the childrens’ behaviours were parallel to adult’s depression and nominated this phenomenon “anaclitic depression” (p. 8). The article does not reveal the fact that actually all of the children’s regressions were not stable: children, whose deprivation duration was less than three months, recovered. If the deprivation lasted longer, they rarely recovered totally. On the other hand, there has been some other hopeful Romanian research in this field: 20-25 percent of adopted children from orphanages recovered from deprivation by the age of six, even though the child’s deprivation occured his/her two first life years. 70 percent recovered fully if deprivation occured less than the child’s first six months. Reflecting these studies, we can argue that later life’s care has revising and unifying impression.
I have represented material that speaks up for the idea that depression is not a compelling destiny. The die has not been cast in childhood. It is all about how we regard depression: we will suffer from it for the rest of our lives if we consider it as a natural, chronic state. But if we see and recognise depression as a state of emergency, we can intervene and stop living half alive.